Orthopedics Book

Ankle Disorders

Approach

Cervical Spine Disorders

Cervicobrachial Disorders

Elbow Disorders

Foot Disorders

Hand Disorders

Hip Disorders

Infectious Disease

Knee Disorders

Lumbar Spine Disorders

Miscellaneous

Shoulder Disorders

Thoracic Spine Disorders

Wrist Disorders

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Elbow Exam

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  1. Observation
    1. Olecranon Tip and the 2 Epicondyles form:
      1. Elbow extended: transverse line
      2. Elbow flexed: isosceles triangle
    2. Olecranon Tip, Lateral Epicondyle, and Radial head
      1. Forms a posterior-lateral triangle
        1. Occupied by anconeus muscle
      2. Excellent site for joint aspiration
      3. Olecranon bursa often bulges in posterior triangle
        1. Joint effusion bulges into antecubital fossa
    3. Carrying Angle
      1. Neutral elbow position with forearm supinated
        1. Males: elbow flexed 5-10 degrees
        2. Females: elbow flexed 10-15 degrees
      2. Injury or infection alters angle (young higher risk)
        1. Cubitus varus (gunstock deformity)
          1. Carrying angle reversed
        2. Cubitus valgus
  2. Normal elbow range of motion
    1. Extension: 0 degrees
    2. Flexion: 150 degrees
    3. Pronation: 70 degrees
    4. Supination: 90 degrees
  3. Strength (resisted Isometric) Mnemonic
    1. MFP: medial (epicondyle) flexors and pronators
    2. LES: lateral (epicondyle) extensors and supinators
  4. Stability Testing
    1. Varus or Valgus stress
      1. Flex elbow to 30 degrees to unlock olecranon
    2. Ulnar collateral ligament injury most common
      1. Very significant injury for pitchers
  5. Palpation
    1. Anterior
      1. Biceps tendon
      2. Median Nerve
      3. Anterior capsule
    2. Posterior
      1. Triceps tendon
      2. Olecranon fossa
    3. Medial
      1. Medial epicondyle
      2. Forearm flexor and pronator tendons
      3. Medial collateral ligament
      4. Ulnar Nerve
    4. Lateral
      1. Lateral epicondyle
      2. Radiocapitellar joint
      3. Radial head
      4. Radial Nerve

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